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Louisiana rates for HCPCS D4355

Full Mouth Debridement To Enable A Comprehensive Periodontal Evaluation And Diagnosis On A Subsequent Visit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.18 / $56.18 / $57.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.20 / $59.35 / $75.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.05 / $90.97 / $92.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.31 / $73.31 / $73.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.00 / $80.00 / $85.00